Reciprocal Peer Support Promising for Diabetes Care

In study, six-month telephone program resulted in decreases in HbA1c

By Lindsey Marcellin

HealthDay Reporter

TUESDAY, Oct. 19 (HealthDay News) -- Compared to a nurse care management (NCM) system, one-to-one reciprocal peer support (RPS) results in greater improvements in hemoglobin A1c (HbA1c) for patients with diabetes, according to research published in the Oct. 19 issue of the Annals of Internal Medicine.

Michele Heisler, M.D., of the University of Michigan in Ann Arbor, and colleagues conducted a randomized study of 244 male patients with an HbA1c level of greater than 7.5 percent during the six months prior to enrollment. The men were assigned to either a six-month trial of NCM, or were paired with another age-matched peer patient and encouraged to talk weekly about diabetes-related issues.
The RPS patients could also participate in optional nurse-facilitated, patient-run group sessions at one, three, and six months.

The researchers found that, in the RPS group, mean HbA1c level decreased from 8.02 to 7.73 percent; the NMS patients had a mean increase from 7.93 to 8.22 percent. For the subgroup of patients having a baseline HbA1c of greater than 8 percent, the mean HbA1c dropped even more significantly in the RPS group, as opposed to a slight increase in the NCM group.

"Although many unanswered questions remain about payment, standards for training laypeople to help others manage disease, and the long-term outcomes of such programs, Heisler and colleagues' study offers additional evidence that we need to move outside of our often-isolated medical practices and partner with the community to improve health outcomes of persons with poorly controlled chronic diseases," write the authors of an accompanying editorial.